Individual
WALTER E DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS/ICCJP/ICCDP
Contact information
Practice address
4728 OXFORD AVE, PHILADELPHIA, PA 19124-5835
(215) 391-8921
Mailing address
7419 BARCLAY RD, CHELTENHAM, PA 19012-1302
(215) 281-8458
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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